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Acta Neurochirurgica

, Volume 158, Issue 5, pp 933–942 | Cite as

Reasons and results of endoscopic surgery for prolactinomas: 142 surgical cases

  • Safak Akin
  • Ilkay Isikay
  • Figen Soylemezoglu
  • Taskin Yucel
  • Alper Gurlek
  • Mustafa BerkerEmail author
Clinical Article - Functional

Abstract

Background

We report herein a retrospective analysis of the results of 142 consecutive prolactinoma cases operated upon using an endoscopic endonasal trans-sphenoidal approach over a period of 6 years.

Methods

Medical records of 142 cases were analysed with respect to indications for surgery, duration of hospital stay, early remission rates, failures and recurrence rates during a median follow-up of 36 months.

Results

On the basis of magnetic resonance imaging (MRI) data, 19 patients (13.4 %) had microadenoma, 113 (79.6 %) had macroadenoma, and the remaining 10 (7.0 %) had giant adenomas. Cavernous sinus invasion was identified in 25 patients by MRI and confirmed during surgery. Atypical adenoma was diagnosed in 16 patients. Sparsely granulated prolactin adenoma was identified in 99 patients (69.7 %). Our results demonstrate that male sex and higher preoperative prolactin levels are independent factors predicting persistent disease. The post-surgical complications are as follows: 2.8 % patients had meningitis, 2.1 % patients had postoperative cerebrospinal fluid leak and 2.1 % patients had panhypopituitarism. At the end of follow-up, 74.6 % patients went into remission. During follow-up period, five patients who had initial remission developed recurrence.

Conclusions

Our series together with literature data suggest that an endoscopic endonasal trans-sphenoidal approach in the treatment of proloctinomas has a favourable rate of remission. According to the findings of this study, endoscopic endonasal trans-sphenoidal surgery might be an appropriate therapy choice for patients with prolactinoma who could not have been managed with recommended therapeutic modalities.

Keywords

Atypical prolactin adenoma Endoscopic endonasal trans-sphenoidal pituitary surgery Pituitary apoplexy Prolactinoma Sparsely granulated prolactin adenoma 

Notes

Acknowledgments

We are thankful to Mr. Khawar Ali for his contributions to English language editing of this manuscript.

Compliance with ethical standards

For this type of study formal consent is not required.

Funding

No funding was received for this research.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Safak Akin
    • 1
  • Ilkay Isikay
    • 2
  • Figen Soylemezoglu
    • 3
  • Taskin Yucel
    • 4
  • Alper Gurlek
    • 1
  • Mustafa Berker
    • 2
    Email author
  1. 1.Faculty of Medicine, Department of Endocrinology and MetabolismHacettepe UniversityAnkaraTurkey
  2. 2.Faculty of Medicine, Department of NeurosurgeryHacettepe UniversityAnkaraTurkey
  3. 3.Faculty of Medicine, Department of PathologyHacettepe UniversityAnkaraTurkey
  4. 4.Faculty of Medicine, Department of OtorhinolaryngologyHacettepe UniversityAnkaraTurkey

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